Microwave bio-sensor based on symmetrical split ring resonator with spurline filters for therapeutic goods detection

A novel symmetrical split ring resonator (SSRR) based microwave sensor with spurline filters for detecting and characterizing the properties of solid materials has been developed. Due to the weak perturbation in the interaction of material under test (MUT) and planar microwave sensor, spurline filters were embedded to the SSRR microwave sensor which effectively enhanced Q-factor with suppressing the undesired harmonic frequency. The spurline filter structures force the presented sensor to resonate at a fundamental frequency of 2.2 GHz with the capabilities of suppressing rejected harmonic frequency and miniaturization in circuit size. A wide bandwidth rejection is achieved by using double spurlines filters with high Q-factor achievement (up to 652.94) compared to single spurline filter. The new SSRR sensor with spurline filters displayed desired properties such as high sensitivity, accuracy, and performance with a 1.3% typical percentage error in the measurement results. Furthermore, the sensor has been successfully applied for detecting and characterizing solid materials (such as Roger 5880, Roger 4350, and FR4) and evidently demonstrated that it can suppress the harmonic frequency effectively. This novel design with harmonic suppression is useful for various applications such as food industry (meat, fruit, vegetables), biological medicine (derived from proteins and other substances produced by the body), and Therapeutic goods (antiseptics, vitamins, anti-psychotics, and other medicines).

Molecular analysis of fragile X syndrome (FXS) among Malaysian patients with developmental disability

Fragile X syndrome (FXS) is a neurodevelopmental disorder commonly found worldwide, caused by the silencing of fragile X mental retardation 1 (FMR1) gene on the X-chromosome. Most of the patients lost FMR1 function due to an expansion of cytosine-guanine-guanine (CGG) repeat at the 5' untranslated region (5'UTR) of the gene. The purpose of this study is to identify the prevalence of FXS and characterize the FMR1 gene CGG repeats distribution among children with developmental disability in Malaysia. Genomic DNA of 2201 samples from different ethnicities (Malays, Chinese, Indian and others) of both genders were PCR-amplified from peripheral blood leukocytes based on specific primers at 5'UTR of FMR1 gene. Full mutations and mosaics were successfully identified by triple methylation specific PCR (ms-PCR) and subsequently verified with FragilEase kit. The findings revealed for the first time the prevalence of FXS full mutation in children with developmental disability in Malaysia was 3.5%, a slightly higher figure as compared to other countries. Molecular investigation also identified 0.2% and 0.4% probands have permutation and intermediate alleles, respectively. The CGG repeats length observation showed 95% of patients had normal alleles within 11 to 44 CGG repeats; with 29 repeats found most common among Malays and Indians while 28 repeats were most common among Chinese. In conclusion, this is the first report of prevalence and characterisation of CGG repeats that reflects genetic variability among Malaysian ethnic grouping.

Duplication 17p11.2 (Potocki-Lupski Syndrome) in a child with developmental delay

Potocki-Lupski syndrome (PTLS), also known as duplication 17p11.2 syndrome, trisomy 17p11.2 or dup(17)(p11.2p11.2) syndrome, is a developmental disorder and a rare contiguous gene syndrome affecting 1 in 20,000 live births. Among the key features of such patients are autism spectrum disorder, learning disabilities, developmental delay, attention-deficit disorder, infantile hypotonia and cardiovascular abnormalities. Previous studies using microarray identified variations in the size and extent of the duplicated region of chromosome 17p11.2. However, there are a few genes which are considered as candidates for PTLS which include RAI1, SREBF1, DRG2, LLGL1, SHMT1 and ZFP179. In this report, we investigated a case of a 3-year-old girl who has developmental delay. Her chromosome analysis showed a normal karyotype (46,XX). Analysis using array CGH (4X44 K, Agilent USA) identified an ~4.2 Mb de novo duplication in chromosome 17p11.2. The result was confirmed by fluorescence in situ hybridization (FISH) using probes in the critical PTLS region. This report demonstrates the importance of microarray and FISH in the diagnosis of PTLS.

ASPP2 deficiency causes features of 1q41q42 microdeletion syndrome

Chromosomal abnormalities are implicated in a substantial number of human developmental syndromes, but for many such disorders little is known about the causative genes. The recently described 1q41q42 microdeletion syndrome is characterized by characteristic dysmorphic features, intellectual disability and brain morphological abnormalities, but the precise genetic basis for these abnormalities remains unknown. Here, our detailed analysis of the genetic abnormalities of 1q41q42 microdeletion cases identified TP53BP2, which encodes apoptosis-stimulating protein of p53 2 (ASPP2), as a candidate gene for brain abnormalities. Consistent with this, Trp53bp2-deficient mice show dilation of lateral ventricles resembling the phenotype of 1q41q42 microdeletion patients. Trp53bp2 deficiency causes 100% neonatal lethality in the C57BL/6 background associated with a high incidence of neural tube defects and a range of developmental abnormalities such as congenital heart defects, coloboma, microphthalmia, urogenital and craniofacial abnormalities. Interestingly, abnormalities show a high degree of overlap with 1q41q42 microdeletion-associated abnormalities. These findings identify TP53BP2 as a strong candidate causative gene for central nervous system (CNS) defects in 1q41q42 microdeletion syndrome, and open new avenues for investigation of the mechanisms underlying CNS abnormalities.

Mesenchymal stromal cells for cartilage repair in osteoarthritis

Treatment for articular cartilage damage is quite challenging as it shows limited repair and regeneration following injury. Non-operative and classical surgical techniques are inefficient in restoring normal anatomy and function of cartilage in osteoarthritis (OA). Thus, investigating new and effective strategies for OA are necessary to establish feasible therapeutic solutions. The emergence of the new discipline of regenerative medicine, having cell-based therapy as its primary focus, may enable us to achieve repair and restore the damaged articular cartilage. This review describes progress and development of employing mesenchymal stromal cell (MSC)-based therapy as a promising alternative for OA treatment. The objective of this review is to first, discuss how in vitro MSC chondrogenic differentiation mimics in vivo embryonic cartilage development, secondly, to describe various chondrogenic differentiation strategies followed by pre-clinical and clinical studies demonstrating their feasibility and efficacy. However, several challenges need to be tackled before this research can be translated to the clinics. In particular, better understanding of the post-transplanted cell behaviour and learning to enhance their potency in the disease microenvironment is essential. Final objective is to underscore the importance of isolation, storage, cell shipment, route of administration, optimum dosage and control batch to batch variations to realise the full potential of MSCs in OA clinical trials.

P16INK4a: a potential diagnostic adjunct for prediction of high-grade cervical lesions in liquid-based cytology: with HPV testing and histological correlation

Human papillomavirus (HPV) is a necessary cause of cervical cancer and its precursors. Increased expression of high-risk hrHPV viral oncogenes in abnormal cells might increase the expression of p16INK4a. We aimed to determine the role of p16INK4a in detecting hrHPV-transformed epithelial cells in liquid-based cervical cytology, and compared the results with hrHPV DNA testing by realtime polymerase chain reaction (RT-PCR). Fifty-seven cytological samples were tested for p16INK4a immunomarker and hrHPV DNA. Test performance of both tests was determined by comparing sensitivity, specificity and predictive values using available histological follow-up data as gold standard. Of 57 samples, 36 (63.2%) showed immunoreactivity for p16INK4a and 43 (75.4%) were hrHPV-infected. A fairly low concordance rate (k = 0.504) between p16INK4a immunolabelling and hrHPV DNA status was noted. For prediction of cervical intraepithelial neoplasia (CIN) II and worse lesions, p16INK4a had a sensitivity and specificity of 93.5% and 60%; whereas hrHPV DNA testing had a sensitivity and specificity of 100% and 20%. Dual testing by combining p16INK4a and hrHPV showed sensitivity and specificity of 100% and 33.3%. In conclusion, p16INK4a is useful in predicting severity of the cytological abnormalities. Although p16INK4a is more specific but less sensitive than hrHPV in detecting high-grade cervical lesions, a combination of both tests failed to demonstrate significant improvement in diagnostic sensitivity, specificity and predictive value. Larger-scale prospective studies are required to assess further whether this biomarker should be routinely used as primary screening tool independently or in combination with hrHPV testing to improve diagnostic accuracy in cervical cytology.

Patient-derived glioblastoma cells show significant heterogeneity in treatment responses to the inhibitor-of-apoptosis-protein antagonist birinapant

Background:

Resistance to temozolomide (TMZ) greatly limits chemotherapeutic effectiveness in glioblastoma (GBM). Here we analysed the ability of the Inhibitor-of-apoptosis-protein (IAP) antagonist birinapant to enhance treatment responses to TMZ in both commercially available and patient-derived GBM cells.

Methods:

Responses to TMZ and birinapant were analysed in a panel of commercial and patient-derived GBM cell lines using colorimetric viability assays, flow cytometry, morphological analysis and protein expression profiling of pro- and antiapoptotic proteins. Responses in vivo were analysed in an orthotopic xenograft GBM model.

Results:

Single-agent treatment experiments categorised GBM cells into TMZ-sensitive cells, birinapant-sensitive cells, and cells that were insensitive to either treatment. Combination treatment allowed sensitisation to therapy in only a subset of resistant GBM cells. Cell death analysis identified three principal response patterns: Type A cells that readily activated caspase-8 and cell death in response to TMZ while addition of birinapant further sensitised the cells to TMZ-induced cell death; Type B cells that readily activated caspase-8 and cell death in response to birinapant but did not show further sensitisation with TMZ; and Type C cells that showed no significant cell death or moderately enhanced cell death in the combined treatment paradigm. Furthermore, in vivo, a Type C patient-derived cell line that was TMZ-insensitive in vitro and showed a strong sensitivity to TMZ and TMZ plus birinapant treatments.

Conclusions:

Our results demonstrate remarkable differences in responses of patient-derived GBM cells to birinapant single and combination treatments, and suggest that therapeutic responses in vivo may be greatly affected by the tumour microenvironment.

Antibiograms, Resistance Genes, Class I Integrons and PFGE profiles of Zoonotic Salmonella in Malaysia

Salmonella infections occur worldwide, in both developed and developing countries, and a major contributor to morbidity and economic costs. A total of 32 Salmonella isolates isolated from dogs (n=15/162), cats (n=1/126) and snakes (n=16/42) in the Klang valley, Peninsular Malaysia during 2012-2013, were used in this study and 6 serovars were identified. The isolates were then characterized for their susceptibility to commonly used antimicrobial agents using the standard disk diffusion method. The presence of relevant resistance genes and class 1 integrons were investigated by using PCR. Pulsed-field gel electrophoresis (PFGE) was carried out to determine the genetic diversity of these Salmonella strains. Higher resistance rates were observed for tetracycline (40.6%), nalidixic acid (21.9%), sulphamethazole-trimethoprim (18.7%), ampicillin (18.7%) followed by chloramphenicol (15.6%), streptomycin (6.25%), enrofloxacin (12.5%), cephalexin (6.25%), cephalothin (6.25%) and amoxicillin-clavulanic acid (3.12%). Nine percent (3/32) presented a single type of resistance, 6% (2/32) showed resistance to two classes of antimicrobials and 34% (11/32) were multidrugresistant (MDR) (resistant to 3 or more antimicrobials). Analysis of the carriage of resistance genes in the isolates revealed that seven (blaTEM-1, strA, strB, sulII, dfrhI, tetA, and cmlA) out of 10 resistance genes were present. Classes 1 integrons were present in 68.75% (11/16) of the resistance strains. PFGE analysis showed that the strains were very diverse and certain PFGE pattern clusters correlated well with antimicrobial resistance phenotypes. In conclusion, high rates of multidrug resistance were found among the dogs Salmonella strains.

Case-control investigation on the risk factors of melioidosis in small ruminant farms in Peninsular Malaysia

AIMS

Epidemiology of melioidosis is poorly understood because its occurrence is influenced by complex interaction of environmental, climatic, physicochemical and host factors. We investigated the potential risk factors for the exposure to Burkholderia pseudomallei in small ruminants' farms in Peninsular Malaysia.

METHODS AND RESULTS

Melioidosis-positive (n = 33) and negative (n = 27) farms were selected and visited for interviews and environmental samples collection. The characteristics and putative disease risk factors were compared between the case and the control farms using Chi-square test and logistic regression analysis. The multivariable logistic regression analysis showed that the odds of melioidosis were significantly higher in farms that had bush clearing around farms (odds ratio (OR) = 6.61, 95% confidence interval (CI) = 1.12-38.84, P = 0.037), in farms with B. pseudomallei present in the soil (OR = 6.23, 95% CI = 1.03-37.68, P = 0.046), in farms that have other animal species present (OR = 7.96, 95% CI = 1.14-55.99, P = 0.037) and in farms that had flooding or waterlogging conditions (OR = 11.95, 95% CI = 1.39-102.6, P = 0.024) when compared to the odds of the disease in farms that did not have the above conditions. The odds of the disease in farms that treated their soils with lime were significantly lower (OR = 0.028, 95% CI = 0.003-0.29, P = 0.003) compared to the odds in those that did not.

CONCLUSIONS

The risk factors for the exposure to B. pseudomallei highlighted above may have contributed to the occurrence of melioidosis in animals in the study farms.

SIGNIFICANCE AND IMPACT OF THE STUDY

Information from the study may be helpful in planning control measures against melioidosis and have improved understanding of the epidemiology of the disease in livestock farms.

Social support and self-care activities among the elderly patients with diabetes in Kelantan

INTRODUCTION

Diabetes is common among the elderly and can significantly affect their lives including the issues related with social support and diabetic self-care activities.

OBJECTIVES

The objective of this study was to examine the social support and self-care activities among the elderly patients with diabetes.

METHODS

A survey involving 200 patients was conducted from March 2013 to May 2013 in three hospitals in Kelantan. Data were obtained through self-administered questionnaires and clinical characteristics were acquired from the patients' records.

RESULTS

The scores for social support (mean = 19.26; SD = 2.63) and self-care activities (mean = 14.83; SD = 4.92) were moderate. Higher social support was associated with high levels of glycated haemoglobin (HbA1c), fasting blood sugar (FBS) level, the duration of diabetes and a decrease in body mass index (BMI) (p<0.05). It was observed that the patients with low educational, Hb1Ac and FBS level, with other chronic diseases and who have had diabetes for some time had low self-care activities (p<0.05). There was a significant negative relationship between an increase in social support and decrease in self-care activity (p<0.05).

CONCLUSION

Healthcare providers, family and friends have to strengthen their relationship with the elderly patients with diabetes to provide more social support and promote the compliance with diabetic self-care activities to improve clinical outcomes.

Abdominal wall reconstruction after resection of an enterocutaneous fistula with an island pedicled anterolateral thigh perforator flap. Case report

Entero-cutaneous fistula resulting from a locally invasive large bowel carcinoma is a difficult surgical challenge. En-bloc resection of the involved organs and the entero-cutaneous fistula tract with a healthy tissue margin will result in a composite abdominal wall defect that requires closure. Reconstructive surgical options include primary closure, components separation and the use of local, regional or free flaps with or without prosthetic mesh. We report a case of an abdominal enterocutaneous fistula secondary to a locally invasive sigmoid carcinoma, which was reconstructed with a pedicled antero-lateral thigh perforator (ALT) flap. To our knowledge, this is the first case of a malignant entero-cutaneous fistula, which was reconstructed with an ALT flap.

Evaluation of the effect of Cassia surattensis Burm. f., flower methanolic extract on the growth and morphology of Aspergillus niger

BACKGROUND AND AIM

Cassia (C.) surattensis Burm. f. (Leguminosae), a medicinal herb native to tropical equatorial Asia, was commonly used in folk medicine to treat various diseases. The aim of the present study is to investigate the effects of methanolic flower extract of C. surattensis against Aspergillus (A.) niger.

MATERIALS AND METHODS

Antifungal activity of C. surattensis flower extract was studied by using agar disc diffusion method, broth dilution method, percentage of hyphal growth inhibition and scanning electron microscopy (SEM) observation.

RESULTS

The extract exhibited good antifungal activity with zone of inhibition 15 mm and minimum inhibitory concentration (MIC) 6.25 mg/ml. The flower extract exhibited considerable antifungal activity against A. niger with a IC50 of 2.49 mg/ml on the hyphal growth. In scanning electron microscopy (SEM) squashed, collapsed, empty and deformation of hyphae were the major changes observed. Shrunken conidiophores were the obvious alteration on the spores. Morphological alterations observed on A. niger caused by the flower extract could be the contribution of chemical compounds present in the Cassia flower. Phytochemical screening reveals the presence of carbohydrate, tannins, saponins and phenols in the extract. The amount of tannin, total phenolics and flavonoids were estimated to be 55.14 ± 3.11 mg/g, 349.87 ± 5.41 mg/g gallic acid equivalent and 89.64 ± 3.21 mg/g catechin equivalent respectively.

CONCLUSIONS

C. surattensis flower extract potently inhibited the growth of A. niger and are, therefore, excellent candidates for use as the lead compounds for the development of novel antifungal agents.

Radiation-induced distal ileal obstruction complicating ileostomy closure

BACKGROUND

Radiation enteropathy is a recognized complication in patients who undergo neoadjuvant radiotherapy for locally advanced rectal cancer. Routine formation of defunctioning loop ileostomy in these patients may mask the development of stricturing, terminal ileal and radiation enteropathy which later may complicate the ileostomy closure. Our aim was to assess the preventive techniques and key warning signs.

METHODS

We present two cases of ileostomy closure in patients with occult, radiation-induced, terminal ileal stricture and review the relevant literature.

RESULTS

The first case was complicated by dehiscence of the ileal anastomosis due to undiagnosed, downstream stenosis of the irradiated terminal ileum. A similar terminal ileal stricture was diagnosed in the second case by contrast fluoroscopy enabling an elective ileocolic anastomosis. The literature indicates the importance of identifying such problems prior to loop ileostomy closure.

CONCLUSIONS

Contrast studies before loop ileostomy closure are valuable in limiting the complications of radiation-induced distal ileal obstruction in selected patients.

Aerosol-based delivery of fibroblast cells for treatment of lung diseases

BACKGROUND

Cell-based therapy has great potential to treat patients with lung diseases. The administration of cells into an injured lung is one method of repairing and replacing lost lung tissue. However, different types of delivery have been studied and compared, and none of the techniques resulted in engraftment of a high number of cells into the targeted organ. In this in vitro study, a novel method of cell delivery was introduced to investigate the possibility of delivering aerosolized skin-derived fibroblasts.

METHODS

Skin-derived fibroblasts were trypsinized and resuspended in growth medium. A syringe filled with cells (10(5) cells/mL) was attached to MicroSprayer(®) Aerosolizer, a device that can modify a liquid into an aerosol. The tip of the MicroSprayer Aerosolizer was channeled into a T25 flask containing growth medium. Survivability following aerosolization was observed on a daily basis. HeLa cells were used for comparison. The same aerosolization and culture methods were used to treat HeLa cells.

RESULTS

One day following aerosolization, skin-derived fibroblasts showed no sign of vacuolation due to cell stress. They attached to the surface of the flask, indicating that most of them survived aerosolization. The surviving cells were also able to proliferate rapidly, forming a confluent monolayer of cells at day 4. In contrast, HeLa cells were unable to proliferate even after 21 days of culture.

CONCLUSIONS

This study provides the first evidence that cells can be aerosolized without the risk of low cell survivability and stress. The high survival rate of fibroblast cells following aerosolization illustrates the potential for delivering of such cells in future aerosol cell-based therapy to treat lung diseases.